Laboratory of Biological Structure Mechanics, Structural Engineering Department, Politecnico di Milano, Piazza L. da Vinci 32, 20133 Milan, Italy.
Ann Biomed Eng. 2013 Jul;41(7):1428-44. doi: 10.1007/s10439-012-0681-6. Epub 2012 Oct 23.
In the last two decades, numerical models have become well-recognized and widely adopted tools to investigate stenting procedures. Due to limited computational resources and modeling capabilities, early numerical studies only involved simplified cases and idealized stented arteries. Nowadays, increased computational power allows for numerical models to meet clinical needs and include more complex cases such as the implantation of multiple stents in bifurcations or curved vessels. Interesting progresses have been made in the numerical modeling of stenting procedures both from a structural and a fluid dynamics points of view. Moreover, in the drug eluting stents era, new insights on drug elution capabilities are becoming essential in the stent development. Lastly, image-based methods able to reconstruct realistic geometries from medical images have been proposed in the recent literature aiming to better describe the peculiar anatomical features of coronary vessels and increase the accuracy of the numerical models. In this light, this review provides a comprehensive analysis of the current state-of-the-art in this research area, discussing the main methodological advances and remarkable results drawn from a number of significant studies.
在过去的二十年中,数值模型已经成为研究支架置入术的公认且广泛应用的工具。由于计算资源和建模能力有限,早期的数值研究仅涉及简化的病例和理想化的支架血管。如今,计算能力的提高使得数值模型能够满足临床需求,并纳入更复杂的病例,如在分叉或弯曲血管中植入多个支架。从结构和流体动力学的角度来看,支架置入术的数值建模都取得了有趣的进展。此外,在药物洗脱支架时代,对药物洗脱能力的新见解在支架开发中变得至关重要。最后,最近的文献中提出了基于图像的方法,能够从医学图像中重建真实的几何形状,旨在更好地描述冠状动脉的特殊解剖特征,并提高数值模型的准确性。有鉴于此,本文对该研究领域的最新技术进行了全面分析,讨论了从许多重要研究中得出的主要方法学进展和显著结果。